Adverse Effects

by Joel Shulkin

  Chapter Sixteen

  “Thanks for picking me up.” Cristina closed her eyes, focusing on the relaxing scents of the leather seats and cinnamon air freshener. She tried to ignore the jarring movements as Andrea swerved her Mazda Miata back and forth between lanes.

  “The T is still shut down, and I couldn’t handle taking the bus alone.”

  “Don’t be silly,” Andrea said. Gears hummed as she upshifted. “You know I’m always here for you.”

  “Mm-hmm.” Eyes closed, Cristina gripped the console.

  “You okay? You look like you’re ready to jump out the window.”

  Cristina forced a smile without opening her eyes. “I’ll be fine.”

  “Relax. We’ll be home before you know it.”

  “Okay.” Cristina slowed her breathing, allowing her mind to drift. The moment she started to feel calmer, Jerry Peterman’s face jarred her thoughts. He shot his victim again and again. Cristina bolted upright.

  Andrea jumped and jerked the steering wheel. The car swerved.

  “What? What happened?” They were headed toward the guardrail. Andrea veered back into the lane. “Jesus, you almost gave me a heart attack.”

  “I’m sorry. I keep seeing Jerry’s face. The whole scene was horrible.”

  “I can only imagine. But don’t blame yourself. He was obviously sick.”

  “That’s just it. Jerry Peterman was happy as could be at his last visit. It’s my job to tell if someone is a threat to himself or others. He’s never seemed unstable. Ever.” Again, she saw Jerry’s final grin. “And here’s the totally bizarre thing: at the end, Jerry had the same smile I saw on Carl Franklin’s face after he died, like they were relieved their suffering was finally at an end. How long were they in pain and I had no idea?” She felt like an undead creature had sucked the life from her body. “Maybe I should quit my job before someone else dies.”

  “Don’t talk like that. Damn it!” Andrea slammed on her brakes as the lights turned red. She twisted in her seat to face Cristina. “I know for a fact that you’ve helped a lot of people who wouldn’t have a chance with anyone else.”

  As much as Cristina wanted to believe that, she kept hearing Jerry’s voice: I needed your help . . . You weren’t there for me.

  “Two patients dead in two weeks, and one of them murdered innocent people,” Cristina managed to say without breaking into tears. “Even for a forensic psychiatrist that would be more than bad luck. Clearly, I failed them.”

  “Enough of that. There’s no way you could’ve known everything, no matter how many questions you asked or how eager they seemed to talk.”

  The light changed.

  Andrea gunned the engine and sped through the intersection. “Everyone has skeletons, you know?”

  As the streetlights whipped past, a wave of nausea overtook Cristina, but it wasn’t only the movement that affected her. She wondered what Andrea would think if she knew Cristina had been meeting clandestinely with the man who had burned down her parents’ house. She snapped her eyes shut. “Could you please slow down?”

  “Oh, sorry, honey.” Andrea eased off the gas. “Is that better?”

  Cristina nodded. Her stomach settled, but she couldn’t shake a feeling of dread. Why had Jerry been hunting someone named Quinn—the name she had shouted in her sleep? Her temples throbbed. She sank deeper into the seat. “I want this night to end.”

  “Did the cops give you a hard time?”

  “No, they were very polite. They took a statement and asked to stop by tomorrow to review my medical records on Jerry. When it became clear his rampage was out of the blue, and everything he was babbling was nonsense, they got tired of babysitting me.”

  “Detective Wilson took care of it, huh?”

  “It’s not his precinct. They said they’d give him a call in the morning.” Cristina brushed a lock of hair out of her eyes and sighed. “Honestly, I’m glad he wasn’t there.”

  “Why?”

  “Are you kidding? With everything that’s happened, he’s going to insist on an escort every time I leave the apartment.”

  “That’s not such a bad idea.” Andrea gave Cristina a sideways glance. “What were you doing in the Commons by yourself, anyway?”

  Cristina’s neck muscles tensed. As much as she wanted to tell Andrea everything—about Zero Dark, the locket, and Santos’s claims—the last thing she needed was a lecture on how irrational and careless she was being. If she hadn’t met Santos or Martins or whoever he was, she would’ve answered her phone and maybe could’ve stopped Jerry. Even though that would haunt her, maybe forever, she was still driven to find the truth. But if she could believe Santos, Zero Dark killed anyone who got in their way. If Andrea knew the truth, it’d be like painting crosshairs on her forehead. Until Cristina knew what Zero Dark wanted from her, she couldn’t risk involving anyone else.

  “This afternoon I remembered skating on the pond with my parents.” As Cristina lied to Andrea, she stared into the side mirror. Who was this woman staring back with dark circles and fear in her eyes? She had thought she knew, but now she wasn’t so sure. “I felt this need to connect with them. I’m sorry. I should’ve called you, but I needed some alone time.”

  “Hey, I know that feeling.” Andrea exited onto Route 128 toward Somerville. “But with everything going on, you can’t take chances. Next time call me, okay?”

  “I will.”

  “You don’t have to suffer alone. You know you can tell me anything, right?”

  “I know.”

  Nearly a hundred potential investors filled the Marriott Wardman Park Hotel ballroom, from advertising executives and movie producers to entre­preneurial millionaires. Champagne had been flowing for hours. Quinn recalled attending parties like this nearly every week up until his third year of college, when his parents cut him off from his trust fund and inheritance. A weaker man might have sunk into drunken despair or sought refuge in religion—but not Quinn. He chose his own path, and now he balanced on the precipice of being more powerful than his parents could have ever dreamed. The right pitch could sell every one of these drunken bastards on the project. He only had to choose the best offer. The senator he’d been approaching when his phone vibrated was a prime target, but Quinn knew better than to keep the individual on the other end of the secure chat waiting.

  After signaling to the senator that he’d return soon, Quinn slipped into the coat room and checked his smartphone. Three words stared back: She was there.

  “Shit,” Quinn muttered.

  The light conversation continued uninterrupted over the string quartet’s rendition of a Chopin concerto. News of the Boston shooting had already diffused through the ballroom, although so far no one had traced the crazed shooter’s medical prescriptions back to ReMind.

  Quinn considered his options. He thought he’d given Santos enough reason to keep his mouth shut—obviously not the case. He should’ve dealt with him permanently, a mistake he wouldn’t make again. But as much as Quinn hated to do it, until he found the rogue, he needed to ensure Cristina Silva would not be a threat.

  Chapter Seventeen

  Outside her apartment building, hailing a taxi, Cristina spotted the front-page headline in the bus stop newspaper dispensers. Park Street Station Massacre. Any frail hope that she had imagined the prior night’s horrible events vanished. Out of the corner of her eye, Cristina caught an old woman staring at her before looking away.

  When Cristina entered her office, Devi was on the phone, scribbling furiously. The office manager widened her eyes when she spotted Cristina and made a flabbergasted expression while indicating an array of sticky notes on her desk.

  “Yes,” she said into the phone, “I’ll give her the message.”

  “What was all that?” Cristina asked after Devi hung up.

  “Robin Roberts’s office. They want an interview.�
�

  “The newswoman Robin Roberts? Interview about what?”

  “Didn’t you watch the news? They identified you on TV as Jerry Peterman’s psychiatrist.”

  A knot formed in Cristina’s stomach. “The police said they wouldn’t give my name to the media until they finished their investigation.”

  “They didn’t. Jerry’s sister said your name in an interview on FOX News.”

  The floor fell away from under Cristina’s feet. “Jerry didn’t have a sister.”

  “Apparently he did. Her name’s Stacey, and she’s pissed. You should’ve seen her ranting and raving.” Devi touched her lip. “Or maybe it’s good you didn’t see it.”

  Cristina wiped her hands over her face and fought the urge to scream. “None of this makes sense. Why wouldn’t Jerry tell me about his sister?”

  “I don’t know, but news travels fast. Some of these messages are from Associated Press, the Globe, the New York Times . . .” She waved her hand over the sticky notes. “The rest are from patients canceling their appointments.”

  “Why are they canceling?”

  “It might be because on television Stacey Peterman claimed you prescribed a combination of off-label antipsychotics and stimulants that caused her brother to have a psychotic break.”

  “That’s ridiculous.”

  “Well, apparently he had an empty pill bottle in his pocket, and the police didn’t know what it was. If you ask me, his sister is a rattlesnake, looking for an excuse to attack someone.”

  Cristina fought to control her expression. The pills had to be Recognate.

  “Devi, hold my calls.”

  She shrugged. “I’ve been doing it all morning. Why stop now?”

  Cristina hurried into her office and turned on the computer. She searched her phone directory until she found and called the number for ReMind. They’d changed it twice since she had joined the study, and she hoped they hadn’t changed it again.

  After a few minutes on hold, a man answered. “ReMind Pharmaceuticals. How can I direct your call?”

  “I need to speak to Frank Alvarez in R & D.”

  “I’m sorry. They’re all in a meeting. I can have someone call you back.”

  “It’s urgent. Tell Frank that Dr. Cristina Silva needs to speak to him.”

  After a sharp intake of breath, the man said, “Please hold, Doctor, while I connect you.”

  Cristina chewed on her cuticles while she waited. She caught herself and placed her hand on her desk. What kind of psychiatrist chewed her fingers? One whose world was falling apart. She closed her eyes. The operator’s reaction was odd, but Cristina didn’t care as long as he got Frank Alvarez on the line. Frank had been her contact since day one. Though they’d exchanged numerous emails, she’d never heard his voice. He seemed like a stickler for details and safety protocols. Hopefully, he’d know what to do.

  The phone clicked.

  “Dr. Silva?” asked a baritone voice.

  “Is this Frank? Thank God. I need to give you a heads-up on—”

  “Dr. Silva, this is Julius Simmons.”

  Cristina was startled. Why was she speaking to ReMind’s CEO?

  “I heard about your connection to the subway shooting.” Simmons clucked his tongue. “A tragedy. How are you handling it?”

  “Not well, but there’s something that didn’t make the news. Jerry Peterman, the shooter, was a subject in the Recognate trials.”

  “I know. Frank Alvarez briefed me an hour ago.”

  “I’m worried about my other patients. I’ll provide whatever information you need for adverse-effect reporting, and if you feel we need to suspend the study—”

  “That’s thoughtful but unnecessary, Doctor. I’m sure you know we found no significant adverse effects during randomized trials.” The sound of papers flipping carried over the phone. “But we’ve only studied Recognate in subjects with stable psychiatric backgrounds. That’s why we screen our referrals so carefully.”

  “Of course, and that’s why I’ve only referred stable patients like Jerry.”

  Simmons made a tsk-tsk sound. “I hardly consider three months in an institution stable.”

  “What are you talking about?”

  “Peterman’s sister Stacey announced on the morning news he’d been hospitalized two years ago for attempted suicide.”

  Cristina reeled as if slapped. “I knew nothing about that.”

  “So I gathered. A phone call confirmed his stay at Franciscan Hospital.” Simmons’s tone turned accusatory. “Dr. Silva, how many other subjects have you referred without properly reviewing their histories?”

  “None. I know what I’m doing.” Cristina braced herself against her desk as her head spun. Two of her patients were dead—she knew what she was doing? “I’m still worried that Recognate may have adverse effects. Another patient of mine—a participant in your study—killed himself two weeks ago. Carl Franklin also had no history of depression. There was no warning.”

  Simmons hesitated. “How long was he taking Recognate?”

  “Almost a year.”

  “Standard dose?”

  “Yes.”

  “Then Recognate was not at fault. Long-term studies in rats showed no toxic effects at standard dose.”

  “But those are rats. How many suicidal rats do you see?”

  “Doctor, I know you’re in a difficult position, but don’t blur the issue by pointing fingers. The fact is amnesiac patients sometimes fail to disclose certain facts, making it necessary to dig deeper.” Something buzzed in the background. “I’m afraid I have another call.”

  “Okay, but, Mr. Simmons—”

  “We’ll provide whatever support you require should the victim’s family seek legal action. You’ve been a valuable resource and we take care of our own, so long as you follow the rules. You have been following the rules?”

  Cristina’s mouth went dry. “Yes, of course.”

  “Then you have nothing to worry about. Thank you for your call.” With a click, he ended the conversation.

  Cristina stared at the phone, more confused than ever. She tried to break it down. Recognate worked on endocannabinoid receptors, the same receptors that bind to marijuana, suppressing norepinephrine—one of the body’s fight-or-flight neurotransmitters. Could an overdose overstimulate the brain and cause psychosis?

  Chewing her lip, Cristina searched for Dr. Morgan’s number on her computer. If the medical examiner found altered neurotransmitter levels in Carl Franklin’s autopsy, it might be enough to prove her theory and convince Simmons at ReMind of the crucial need for further study.

  As she picked up her phone, the intercom buzzed.

  “Devi,” she said after pressing the button, “I asked you to hold my calls.”

  “I know, but you have a visitor.”

  “I’m not talking to reporters.”

  “What about Detective Wilson?”

  With everyone else seemingly against her, Cristina knew that potentially having a cop on her side was a good thing. “Send him in.”

  Chapter Eighteen

  “Detective.” Cristina smiled when Wilson entered her office.

  His navy-twill suit clung nicely to his well-proportioned frame.

  She averted her gaze. “Is this about Stacey Peterman’s claims? I had no idea—”

  “This isn’t about Jerry Peterman. I need you to help me with something.”

  She blinked, taken aback. “Sure. Whatever you need.”

  “Your parents were killed in a car wreck, right?”

  “Yes, I told you that.”

  “You had a head injury.”

  “Yes.”

  “And you lost all memory of events before the wreck.”

  Her neck muscles tightened. “Where are you going with this?”

 
“The brake lines were severed. It looked like they’d been cut.”

  “They weren’t cut. They snapped after someone ran us off the road.”

  “Right. That’s what the forensics report said.” He nodded and scratched his chin. “Two days before the crash, you took the car to a mechanic. Do you recall his name?”

  “Detective, I don’t remember anything about that week. I still have partial amnesia.”

  “Right, right.” He glanced at her diplomas. “Francisco Martins.”

  “What about him?”

  “He was the mechanic. The same Francisco Martins that burned down your parents’ house.” He tapped his temple and flashed a lopsided grin. “Weird coincidence, huh?”

  Feeling lightheaded, Cristina sat on the corner of her desk. “I didn’t know anything about this.”

  “Bad things happen to you when this guy pops into your life, and now he’s in town and your apartment gets ransacked. It’s like you two are connected.”

  Cristina pressed her fingers against her forehead, fighting to stay in control of her emotions. Santos had admitted to burning down her parents’ house as Francisco Martins. Was he responsible for their deaths also? “Are you accusing me of having something to do with the crash that killed my parents?”

  “I’m not accusing you of anything. I’m trying to get the facts straight.” He stuck his hands in his pockets. “But I learned your parents had a substantial life insurance policy and you were the sole inheritor.”

  Anger roiled in Cristina’s gut. It took all her strength to force it down.

  “Detective, I lost everything. I’ve been living without a past. I had to rebuild my life from the bottom up.” Tears lurked at the corners of her eyes, but she fought them back. She wasn’t about to let this man see her cry. “I can’t explain to you why Francisco Martins keeps appearing in my life, but I assure you there’s nothing I want more than to see whoever killed my parents brought to justice.”